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Case report and review of the literature: the utilisation of a ventricular assist device as bridge to recovery for anthracycline-induced ventricular dysfunction

Published online by Cambridge University Press:  04 December 2017

Diane Krasnopero ,
Alfred Asante-Korang ,
Jeffrey Jacobs ,
Stacie Stapleton ,
Jennifer Carapellucci ,
Mathew Dotson  and
Gary Stapleton
Diane Krasnopero*
Affiliation:
Johns Hopkins All Children’s Heart Institute, Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, United States of America
Alfred Asante-Korang
Affiliation:
Johns Hopkins All Children’s Heart Institute, Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, United States of America
Jeffrey Jacobs
Affiliation:
Johns Hopkins All Children’s Heart Institute, Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, United States of America Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Stacie Stapleton
Affiliation:
Johns Hopkins All Children’s Cancer and Blood Disorder Institute, Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, United States of America
Jennifer Carapellucci
Affiliation:
Johns Hopkins All Children’s Heart Institute, Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, United States of America
Mathew Dotson
Affiliation:
Johns Hopkins All Children’s Heart Institute, Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, United States of America
Gary Stapleton
Affiliation:
Johns Hopkins All Children’s Heart Institute, Johns Hopkins All Children’s Hospital, St. Petersburg, Florida, United States of America
*
Correspondence to: D. Krasnopero, DNP, Johns Hopkins All Children’s Heart Institute, Johns Hopkins All Children’s Hospital 601 5th Street South, Suite 206, St. Petersburg, FL 33701, United States of America. Tel: 727 767 3333; Fax: 727 767 8990; E-mail: [email protected]
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Abstract

Ventricular assist devices are used in children with heart failure as a bridge to myocardial recovery or cardiac transplantation. Anthracyclines cause cardiac toxicity and may result in acute or long-term cardiac failure. We describe the use of a ventricular assist device as a bridge to recovery in a child with severe acute anthracycline-induced cardiomyopathy, and we review the associated literature. A 6-year-old girl was treated for acute myeloblastic leukaemia with daunorubicin and mitoxantrone. After 2 weeks her final dose of chemotherapy, her Left Ventricular Ejection Fraction decreased to 21%. Despite initiation of medical therapy, she had continued deterioration of left ventricular function and developed evidence of poor end-organ perfusion. She was not a candidate for cardiac transplantation, as the post-transplant immune suppression therapy would put her at risk for recurrence of her malignancy. We placed her on a short-term ventricular assist device as a bridge to ultimately placing her on a long-term ventricular assist device versus continuing medical therapy. Her left ventricular ejection fraction improved to 55% 24 days after ventricular assist device insertion. She was separated from the ventricular assist device 26 days after its insertion. She was discharged home 29 days later and is now 28 months after ventricular assist device implantation with stable ventricular function, as documented by a left ventricular ejection fraction of 55%, and normal end organ function. This case is one of the only reports known describing successful use of a short-term ventricular assist device as a bridge to recovery in a child with severe acute anthracycline-induced cardiotoxicity.

Keywords

Ventricular assist devicecardiotoxicitychemotherapy-induced cardiomyopathysurgery
Type
Brief Report
Information
Cardiology in the Young , Volume 28 , Issue 3 , March 2018 , pp. 471 - 475
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Copyright
© Cambridge University Press 2017 

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References

1. The NIH National Cancer Institute. Bortezomib and sorafenib tosylate in treating patients with newly diagnosed acute myeloid leukemia. Retrieved December 23, 2016 from https://www.cancer.gov/about-cancer/treatment/clinical-trials/search/view?cdrid=701850.Google Scholar
2. Baumann Kreuziger, LM. Management of anticoagulation and antiplatelet therapy in patients with left ventricular assist devices. J Thromb Thrombolysis 2015; 39: 337–344.Google Scholar
3. Edmonton Anticoagulation and Platelet Inhibition Protocol. Retrieved December 23, 2016 from http://www.meduniwien.ac.at/kiklipedia/images/9/9a/Edmonton_Protokoll_Antikoagulation.pdf.Google Scholar
4. Smith, LA, Cornelius, VR, Plummer, CJ, et al. Cardiotoxicity of anthracycline agents for the treatment of cancer: systematic review and meta-analysis of randomized controlled trials. BMC Cancer 2010; 10: 337.Google Scholar
5. Harake, D, Franco, V, Henkel, J, Miller, T, Lipshultz, S. Cardiotoxicity in childhood cancer survivors: strategies for prevention and management. Future Cardiol 2012; 8: 647–670.CrossRefGoogle ScholarPubMed
6. Krischer, JP, Epstein, S, Cuthbertson, DD, Goorin, AM, Epstein, ML, Lipshultz, SE. Clinical cardiotoxicity following anthracycline treatment for childhood cancer: The Pediatric Oncology Group experience. J Clin Oncol 1997; 15: 1544–1552.Google Scholar
7. van Dalen, EC, van der Pal, HJH, Bakker, PJM, Caron, HN, Kremer, LCM. Cumulative incidence and risk factors of mitoxantrone-induced cardiotoxicity in children: a systematic review. Eur J Cancer 2003; 40: 643–652.Google Scholar
8. Gharib, MI, Burnett, AK. Chemotherapy-induced cardiotoxicity: current practice and prospects of prophylaxis. Eur J Heart Failure 2002; 4: 235–242.CrossRefGoogle ScholarPubMed
9. Posner, LE, Dukart, G, Goldberg, J, Bernstein, T, Cartwright, K. Mitoxantrone: an overview of safety and toxicity. Invest New Drugs 1985; 3: 123–132.Google Scholar
10. Shann, KG, Giacomuzzi, CR, Harness, L, et al. Complications relating to perfusion and extracorporeal circulation associated with the treatment of patients with congenital cardiac disease: Consensus Definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease. In: 2008 Supplement to Cardiology in the Young: Databases and The Assessment of Complications associated with The Treatment of Patients with Congenital Cardiac Disease, Prepared by: The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease, Jacobs JP (eds). Cardiol Young, 2008; 18 (Suppl 2): 206–214.Google Scholar
11. Cooper, DS, Pretre, R. Clinical management of pediatric ventricular assist devices. Pediatr Crit Care Med 2013; 14: S27–S36.Google Scholar
12. Jefferies, JL, Morales, DL. Mechanical circulatory support in children: bridge to transplant versus recovery. Curr Heart Fail Rep 2012; 9: 236–243.Google Scholar
13. O’Connor, MJ, Rossano, JW. Ventricular assist devices in children. Curr Opin Cardiol 2014; 29: 113–121.Google Scholar
14. Thiagarajan, RR, Almond, CS, Cooper, DS, Morales, DL. Ventricular assist devices for mechanical circulatory support in children. World J Pediatr Congenit Heart Surg 2012; 3: 104–109.Google Scholar
15. Wilmot, I, Lorts, A, Morales, D. Pediatric mechanical circulatory support. Korean J Thorac Cardiovasc Surg 2013; 46: 391–401.Google Scholar
16. Kurihara, C, Nishimura, T, Nawata, K, et al. Successful bridge to recovery with VAD implantation for anthracycline-induced cardiomyopathy. J Artif Organs 2011; 14: 249–252.CrossRefGoogle ScholarPubMed
17. Schweiger, M, Dave, H, Lemme, F, et al. Acute chemotherapy-induced cardiomyopathy treated with intracorporeal left ventricular assist device in an 8-year-old child. ASAIO J 2013; 59: 520–522.Google Scholar
18. Cavigelli-Brunner, A, Schweiger, M, Knirsch, W, et al. VAD as bridge to recovery in anthracycline-induced cardiomyopathy and HHV6 myocarditis. Pediatrics 2014; 134: e894–e899.Google Scholar
19. Freilich, M, Stub, D, Esmore, D, et al. Recovery from anthracycline cardiomyopathy after long-term support with a continuous flow left ventricular assist device. J Heart Lung Transplant 2009; 28: 101–103.Google Scholar
20. Schranz, D, Akintuerk, H, Voelkel, NF. ‘End-stage’ heart failure therapy: potential lessons from congenital heart disease: from pulmonary artery banding and interatrial communication to parallel circulation. Heart 2017; 103: 262–267.Google Scholar
21. Latus, H, Hachmann, P, Gummel, K, et al. Biventricular response to pulmonary artery banding in children with dilated cardiomyopathy. J Heart Lung Transplant 2016; 35: 934–938.CrossRefGoogle ScholarPubMed